Longitudinal melanonychia in children. A study of eight cases

Leaute-Labreze, C.

doi:10.1001/archderm.132.2.167

Cited by 16 publications

(22 citation statements)

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“…On the other hand, atypical melanocytic hyperplasia or melanoma was more frequently or uniquely diagnosed in adults than in pediatric cases, which was concordant with the results of previous studies [6,[12][13][14].…”

Section: Discussionsupporting

confidence: 91%

“…In contrast, LM caused by melanoma in children is extremely rare, with only a few cases having been reported [8][9][10][11]. Previous studies have shown that melanoma is an uncommon cause of childhood LM [6,[12][13][14]. Furthermore, childhood cases diagnosed as nail apparatus melanoma may behave differently from subungual melanoma in adults, with only in situ melanoma ever reported [8][9][10][11]15].…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Tseng¹,

Liang²,

Liau³

et al. 2017

Dermatology

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Background: Longitudinal melanonychia (LM) may occur as a result of nail apparatus melanoma. Knowledge of etiology plays an important role in the management of LM. Objectives: The study is aimed to compare the diagnosis of LM in different age groups. Methods: We collected 63 cases (45 adults and 18 children) with LM who underwent nail matrix biopsy or excision in a 21-year cohort and assessed their clinicopathological features. Results: Melanomas in adults and children were 40% and none, while nevi accounted for 15.6% in adults and 94.4% in children. There was a statistically significant difference between the average age at diagnosis for melanoma (54.5 ± 13.3 years) and nevus (15.2 ± 18.5 years). Logistic regression related the occurrence of melanoma to older ages with a relative risk of 1.2 compared to nevus, but no cutoffs between age groups could be deﬁned between LM-associated nevus and melanoma. Conclusion: The adult group has a significantly higher risk of melanoma, while children with LM show mostly nonmelanoma etiologies. Tissue proof is more warranted in adult cases, and it is needed in selected cases of children with LM.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Tseng¹,

Liang²,

Liau³

et al. 2017

Dermatology

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“…Nevi can be congenital or acquired, and the majority are junctional [1, 2, 8, 31, 32]. One half of cases of nevi are characterized by a bandwidth of over 3 mm, two-thirds by melanic brown-black pigmentation, and one-third by melanic periungual pigmentation [2].…”

Section: Melanonychiamentioning

confidence: 99%

Melanonychia

Jefferson

Rich

2012

Dermatology Research and Practice

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Melanonychia, or melanin-derived brown-to-black nail pigmentation, is a diagnostic challenge for clinicians. The most serious disease of the nail unit, melanoma, primarily presents with melanonychia. However, melanonychia most often occurs as a result of benign etiologies such as nail matrix melanocytic activation, nail matrix melanocytic hyperplasia, and nail invasion by melanin-producing pathogens. Regrettably, patients with nail apparatus melanoma are often initially misdiagnosed, and due to diagnostic delays of an average of 2 years, melanoma of the nail unit carries a poor prognosis. Having a thorough knowledge of the various causes of melanonychia and using a systematic approach when evaluating brown-to-black nail pigmentation may help prevent misdiagnosis and thereby improve prognosis.

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“…This inevitably leaves a scar in the matrix, which when the diameter of the biopsy is larger than 3 mm will transform into nail dystrophy. Based on published reports[13–15] and experience, with more than 50 cases of longitudinal melanonychia,[16–18] we have devised a biopsy technique that does not cause a matrix scar. [19] Histopathology has shown that almost all benign melanocytic lesions of the matrix are very superficial, either foci of melanocyte activation, lentigines or junctional naevi.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…[19] Histopathology has shown that almost all benign melanocytic lesions of the matrix are very superficial, either foci of melanocyte activation, lentigines or junctional naevi. [13–18] The dermis is free from melanocytes, and only an occasional melanophage is seen. Measuring the thickness of a biopsy down to the bone and of an intra-epithelial pigment lesion demonstrates that the latter is less than 5% of the entire thickness.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Advanced nail surgery

Haneke

2011

J Cutan Aesthet Surg

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Six techniques not yet widely known or used in the dermatologic surgery of the nails are briefly described. Small-to-medium-sized tumours of the proximal nail fold (PNF) can be excised and the defect repaired with advancement or rotation flaps. A superficial biopsy technique of the matrix for the diagnosis of longitudinal brown streaks in the nail, which allows rapid histological diagnosis of the melanocyte focus to be performed, is described here. Because the excision is very shallow and leaves the morphogenetic connective tissue of the matrix intact, the defect heals without scarring. Laterally positioned nail tumours can be excised in the manner of a wide lateral longitudinal nail biopsy. The defect repair is performed with a bipedicled flap from the lateral aspect of the distal phalanx. Malignant tumours of the nail organ often require its complete ablation. These defects can be covered by a full-thickness skin graft, reversed dermal graft, or cross-finger flap. The surgical correction of a split nail is often difficult. The cicatricial tissue of the matrix and PNF have to be excised and the re-attachment of these wounds prevented. The matrix defect has to be excised and sutured or covered with a free matrix graft taken either from the neighbouring area or from the big toe nail.

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Longitudinal melanonychia in children. A study of eight cases

Cited by 16 publications

References 0 publications

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Melanonychia

Advanced nail surgery

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